Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Herring classification: how useful is the initial radiograph?

Kieran Lappin1, David Kealey, Aidan Cosgrove

  • 1Musgrave Park Hospital and Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland. kieranlappin@hotmail.com

Journal of Pediatric Orthopedics
|July 20, 2002
PubMed
Summary

The Herring classification predicts femoral head deformity in Perthes disease. Initial Herring grading accuracy improves with longer symptom duration, with 7 months being a key time point for stability.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Atypical Triplane Ankle Fracture - Antero-Medial Epiphyseal Separation and the Unfused Growth Plate: A Case Report.

Journal of orthopaedic case reports·2025
Same author

Should closed reduction of the dislocated hip be attempted after failed Pavlik harness treatment in developmental dysplasia of the hip?

Bone & joint open·2021
Same author

The Effect of the COVID-19 Pandemic on the Workload of an Adult Major Trauma Centre in Northern Ireland.

The Ulster medical journal·2021
Same author

CORR Insights®: Guided Growth Improves Coxa Valga and Hip Subluxation in Children with Cerebral Palsy.

Clinical orthopaedics and related research·2019
Same author

Functional outcomes following syndesmotic fixation: A comparison of screws retained in situ versus routine removal - Is it really necessary?

Injury·2013
Same author

Two cases of importation of New Delhi Metallo-β-lactamase 1 into Northern Ireland.

The Ulster medical journal·2013

Area of Science:

  • Orthopedics
  • Pediatric Orthopedics
  • Radiology

Background:

  • The Herring lateral pillar classification is a tool for predicting femoral head deformity in Perthes disease.
  • However, initial Herring classifications can be misleading regarding long-term outcomes due to potential further collapse.

Purpose of the Study:

  • To evaluate the predictive accuracy of the initial Herring classification for outcomes in Perthes disease.
  • To determine the influence of symptom duration on the reliability of the initial Herring classification.

Main Methods:

  • Retrospective review of radiographs from 253 patients (275 hips) undergoing conservative treatment for Perthes disease.
  • Herring grade assessment on initial and follow-up radiographs to identify changes.
  • Analysis of symptom duration relative to Herring grade changes.

Related Experiment Videos

Main Results:

  • Ninety-two hips (33.5%) required an upgrade in Herring grade on subsequent radiographs, indicating further collapse.
  • Hips requiring upgrading had a shorter average duration of symptoms (108 days) before the initial radiograph compared to those with no change (204 days).
  • Predictability of the initial Herring classification is significantly correlated with the time elapsed since symptom onset.

Conclusions:

  • The initial Herring classification's predictability in Perthes disease is time-dependent.
  • Longer symptom duration before initial assessment leads to more accurate Herring grading.
  • Approximately 7 months of symptom duration appears to be the average time point beyond which further collapse is less likely.